King’s confident start to reign forced off course by cancer diagnosis

King Charles pictured leaving the London Clinic with the Queen after his treatment for an enlarged prostate in January
The King pictured leaving the London Clinic with the Queen after his treatment for an enlarged prostate in January - Heathcliff O’Malley
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When he acceded the throne 17 months ago, the King pledged to dedicate his life to the service of his people.

At his Coronation less than a year ago, the man once known as the longest-serving heir to the throne felt the weight of the St Edward’s Crown on his head as a new era began.

After 52 years as a campaigning Prince of Wales, and 70 as Queen Elizabeth II’s heir apparent, King Charles III would finally come to realise the reign he could have long imagined.

As King, there would be less campaigning and more convening – but nevertheless, he had plans to help.

Now he is left to contemplate not what he can do but what he can manage. After a reign that has so far included two state visits, three overseas tours and 516 engagements last year, the King will now have to – temporarily – slow down.

After a diagnosis of unspecified cancer, he is to continue some state duties at home but must abandon public engagements while he receives treatment.

“His Majesty would like to apologise to all those who may be disappointed or inconvenienced as a consequence,” said his spokesman.

It is less than three weeks since the world learned that the King was not well.

It did not initially seem too serious. On Jan 17, Buckingham Palace announced that the monarch would receive treatment for an enlarged prostate, “in common with thousands of men each year”, and would have a short period off to recover.

On the day, the breaking news was somewhat overshadowed by the Princess of Wales’s more immediately serious abdominal surgery.

“His Majesty’s condition is benign,” said the palace. He would attend hospital the next week for a corrective procedure, followed by a “short period of recuperation”.

Sadly, it was not that simple. The history books will report that it was instead the first clue of what is now known to be an infinitely more serious diagnosis.

At the time, it is said that even the King himself had no idea that his condition was anything more than a manageable ailment that would be a short disruption to his work.

He was in Scotland as the palace released the first statement about his condition. When the Queen went out on a local engagement the next day, Jan 18, she said he was feeling “fine” and “looking forward to getting back to work”.

A young girl holds a get well card for King Charles following his treatment for an enlarged prostate last month
A young girl holds a get well card for King Charles following his treatment for an enlarged prostate last month - Adrian Dennis/AFP

On the 19th, he was photographed in a car leaving Birkhall, on the Balmoral Estate, and then flew to Sandringham, where he spent the weekend gathering his thoughts and getting as much of his paperwork cleared as possible.

By Jan 25, he arrived at Buckingham Palace from Sandringham by helicopter and was seen waving at tourists from the back of his car on the short journey to Clarence House, where he lives.

The next day, he entered the London Clinic, where he first visited his daughter-in-law. In what seemed to be an indication of their respective health, he went to her bedside.

Six hours later, a relieved-looking Queen Camilla emerged smiling and relaying that the King was already “doing well, thank you”.

He spent three nights in hospital, a little longer than originally expected, but palace aides played down any change in circumstances and pointed out that it was still in line with the one to three-day average hospital stay for his type of treatment.

All fears seemed to dissipate when, on Mon 29, the King walked confidently out of hospital, waving to well-wishers as if he was on an ordinary engagement.

A reassured public saw the steadying hand of a monarch already back in action, even if he needed a little time away from the cameras.

“His Majesty would like to thank the medical team and all those involved in supporting his hospital visit, and is grateful for all the kind messages he has received in recent days,” said the palace.

During his time in hospital, he had received plaudits for his openness in sharing his diagnosis, the NHS reporting a major boost in public awareness. There was a 1,000 per cent rise in people searching for enlarged prostate symptoms online.

A few days later, the Queen made a curious remark. Having repeatedly said her husband was “doing well”, when asked how he was as she attended the opening of a new Maggie’s cancer support centre at the Royal Free Hospital in London, she said he was “getting on” and “doing his best”.

By that point, the couple were already burdened with the knowledge that all was not well. A second problem had been spotted during his treatment, and they awaited results.

In the following days, the King learned he had cancer. He told his family – his two sons, on opposite sides of the Atlantic, and his three siblings. On Monday, the palace machinery geared up to share the news.

The King’s closest aides were informed, and information including the plan of action was relayed to the Government. Leaders of each of the UK nations and the realms, where the King is also head of state, were told.

Rumours began to swirl in the early evening and an announcement came, as with all major royal updates, in time for the six o’clock news.

The King is “wholly positive about his treatment”, and the Queen is steeled to support him.

His heir, Prince William, stands ready to step in where he can, and even his younger son Prince Harry will shortly be by his side, catching a transatlantic flight.

In a matter of hours on Monday, the Royal family’s world shifted on its axis, and Britain with it. Along with the shock, there was a sense within palace walls of some relief that the cancer had been spotted early.

The King’s diary will be hastily rejigged. The unwelcome interruption of the Covid lockdown has prepared the Royal family for periods of working from home – the King can hold meetings via videolink, and it will not seem the constitutional crisis it might once have done.

In September 2022, when Queen Elizabeth II died and Charles acceded to the throne, he pledged to follow in the example she set over a lifetime of royal duty.

“In this purpose, I know that I shall be upheld by the affection and loyalty of the peoples whose sovereign I have been called upon to be,” he said. “In all this, I am profoundly encouraged by the constant support of my beloved wife.

“And in carrying out the heavy task that has been laid upon me, and to which I now dedicate what remains to me of my life, I pray for the guidance and help of Almighty God.”

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